An October 20-22, 2013, Fox News national poll revealed that the implementation of ObamaCare (the Patient Protection and Affordable Care Act) by the American state has been so chaotic that 60% of registered voters characterize the process as “a joke.” The economic reasons for the incompetence are well known by libertarians familiar with the Austrian tradition of economics. The origin of this disorganization might not be as clear to those lacking this economic perspective, as the economist Ludwig von Mises noted in Bureaucracy,

The plain citizen compares the operation of the bureau with the working of the profit system, which is more familiar to him. Then he discovers that bureaucratic management is wasteful, inefficient, slow, and rolled up in red tape. He simply cannot understand how reasonable people allow such a mischievous system to endure.

In the final sentence of the preceding excerpt Mises exposed another crucial misconception about the state. Libertarians have argued for a century or more, state bureaucrats are “reasonable people.” Public choice theory, a venerable branch of economics (evidenced by the awarding of the Nobel Prize in Economics to five proponents: James Buchanan, George Stigler, Gary Becker, Vernon Smith and Elinor Ostrom), has confirmed the libertarian hypothesis by demonstrating that the behavior of state bureaucrats is fundamentally selfish — labeled self-interested in the academic literature. In reality, state bureaucrats are functionaries for a professional criminal class (the ruling members of the state apparatus). What is the purpose of this “mischievous system” championed by this professional criminal class? George Orwell furnished the definitive answer in this extract from his classic dystopian novel 1984,

The Party seeks power entirely for its own sake. We are not interested in the good of others; we are interested solely in power. Not wealth or luxury or long life or happiness: only power, pure power. … We know that no one ever seizes power with the intention of relinquishing it. Power is not a means; it is an end. One does not establish a dictatorship in order to safeguard a revolution; one makes the revolution in order to establish the dictatorship. The object of persecution is persecution. The object of torture is torture. The object of power is power.

Orwell explains that the purpose of increased state healthcare power is not, as the current emperor contends, “to provide affordable, quality healthcare for all Americans and reduce the growth in health care spending.” Rather, the purpose of increased state healthcare power is to increased state healthcare power. The escalation of state power is not a phenomenon previously unknown to the American medical market, particularly on the macroeconomic scale. The Food and Drug Administration, Medicare, and Medicaid are three morally and fiscally bankrupt examples.

If increased state healthcare power is not the solution for a dysfunctional healthcare system, what policies should be espoused “to provide affordable, quality healthcare for all Americans and reduce the growth in health care spending?” Libertarians recognize that a series of steps must be taken to rectify the injustices perpetrated by the current corporate state system. Such proposals are not presented as dessert options on a “reform” menu. Instead, the comprehensive adoption of the following libertarian program by the American society is the just approach. This course would not only maximize the benefits of this radical change for the most vulnerable Americans, but also minimize the duration of the transition pain for those advantaged — unknowingly — by the existing structure: